How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $234.42 Median $1,348.96 Typical High $5,623.41 | Facility | None | $234.42 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $234.42 | Professional | None | $144.54 | $199.53 | $234.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,949.84 | Facility | None | $741.31 | $1,071.52 | $1,949.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $446.68 | Professional | None | $165.96 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $1,148.15 | Facility | None | $478.63 | $891.25 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $457.09 | Professional | None | $147.91 | $245.47 | $457.09 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $741.31 | Professional | None | $190.55 | $331.13 | $741.31 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $316.23 | Professional | None | $186.21 | $194.98 | $316.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $323.59 | Professional | None | $33.11 | $33.11 | $323.59 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,090.30 | Facility | None | $446.68 | $1,047.13 | $3,090.30 |
United Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $426.58 | Professional | None | $151.36 | $245.47 | $426.58 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $162.18 |
Where Illinois sits
The same service costs 4.2 times more in Alaska than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Illinois· 34th of 51
$245
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.